| NPI | 1487698908 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363AM0700X Physician Assistant Medical (Licence: MA PA1715) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: MA PA1715) |
| Enumeration Date | 2006-06-15 |
| Last Update Date | 2024-04-03 |